Optical radiation is currently used to treat a variety of dermatological conditions, including various vascular lesions (for example spider veins, facial telangiectasia, port wine stains, rosacea and erythema, spider angioma, poikloderma of civatte, pyogenic granuloma, venous lakes, cherry anginoma, leg telangiectasia, varicose veins, and hemangioma), skin rejuvenation by regeneration of collagen in the affected area to improve skin texture, eliminating wrinkles, scars and the like, psoriasis, hair growth control, acne, etc. Conventional treatments for vascular lesions have involved the use of lasers operating in a wavelength band from approximately 520 nm to 600 nm for shallow veins, wavelengths at which blood has relatively high absorption and at wavelengths from approximately 750 nm to 1060 nm for deep veins, but have generally not operated at wavelengths below 488 nm. Where broad spectrum lamps are used, the lamps have typically been band-pass filtered to operate in a range of approximately 510 nm to 1,200 nm, depending on a number of factors, including the size of the vessel on which treatment is to be performed. For example, U.S. Pat. Nos. 5,620,478 and 5,755,751 reflect conventional wisdom, suggesting wavelength bands as follows:    Arteries less than 0.1 mm in diameter—520 to 650 nm;    Veins less than 0.1 mm in diameter—520 to 700 nm;    Vessels between 0.1-1.0 mm in diameter—550 to 1,000 nm; and    Larger vessels—600 to 1,000 nm.
However, most of the wavelength bands at which blood has conventionally been treated are also absorbed fairly strongly by melanin. Since there are melanin concentrations in the epidermis of substantially all individuals, such melanin typically being concentrated at the dermal/epidermal junction (DE junction) and there is significant melanin concentration in the epidermis for dark skinned or tanned individuals, the use of these wavelengths to treat vascular lesions and other dermatological and cosmetic conditions can also result in significant heating of the epidermis, and thus cause potential damage to the epidermis, especially for dark skinned patients. This has limited the optical radiation dosage which can be applied in some applications and has frequently required cooling of the epidermis, sometimes aggressive cooling, which can add significantly to the cost of the apparatus used for the treatment, and can also make the apparatus bulky and more difficult to use. Even with cooling, heating of the epidermis may result in some patient discomfort, and may even prevent treatment from being performed on certain very dark skinned individuals.
Similarly, water is present in all cells and intercellular space of the body so that targeting water can also result in the heating of epidermal tissue and other tissue outside of the desired treatment area. Thus, care must again be exercised to assure that the treatment does not result in undesired epidermal or other tissue damage. Because of this, phototreatment of vascular targets can currently be performed only by an experienced physician or other highly trained person in a clinical setting using expensive apparatus.
A need therefore exists for improved methods and apparatus, and in particular, safer and/or more effective methods and apparatus, for treating various vascular related conditions including, but not limited to, treating vascular lesions, performing skin regeneration, and treating other skin conditions associated with organs or other body elements having blood supply systems, particularly ones involving treatment of small blood vessels relatively close to the skin surface, for example within approximately 0.5 mm of the skin surface. Such small vessels would include veins and arteries in the papillary dermis in general, including the plexus, and in particular, small blood vessels in the plexus and spider veins. However, the need for safer and/or more effective treatment methods and apparatus also exists for deeper and/or larger vessels. Such safer and more effective treatment may facilitate the performance of such treatments in spas, salons, the home and other non-clinical settings.